Clinician’s attitudes towards caesarean section: A cross-sectional survey in two tertiary level maternity units in Ireland

Abstract

BackgroundAlthough caesarean section (CS) is a life-saving intervention when medically indicated, the growth in CS rates is causing concern. In reducing unnecessary CS, it is important to understand clinicians’ attitudes towards CS so that these might be understood contextually. ObjectiveTo explore clinicians’ attitudes towards CS in Ireland. MethodsA cross sectional survey involving maternity care professionals in two urban maternity hospitals in Ireland. Descriptive statistics were used to analyse the data. Ethical approval was granted by the Research Ethics Committees of the University and the two study sites. FindingsOne hundred and fifty-two maternity care professionals responded to the survey. Most (97%) indicated that the CS rate in their unit was ‘high’, although 81% believed there was a shift in culture towards a lower threshold for performing CS. Most participants (85%) considered birth a natural process that should not be interfered with unless necessary and that elective CS is not the safest option for the mother (74%) or baby (71%), yet 45% believed that a woman should be able to have a CS if she wants a CS. Just over half the participants considered a previous 3rd or 4th degree tear an indication for an elective CS. Offering vaginal birth after a previous CS for fetal distress and failure to progress increased with clinical experience. ConclusionThe findings of this survey can be considered contextually in addressing high CS rates and will be of wider relevance in understanding maternity care providers’ beliefs about CS in general.